If you start as a resident doctor (Assistenzarzt) in Germany, pay depends on your employer. For university hospitals run by the states, the TV-Ärzte TdL collective agreement usually applies, while many municipal hospitals apply the TV-Ärzte VKA. This guide shows the basic pay in your first year, when statutory health insurance remains compulsory and when you must join the doctors pension fund (Ärzteversorgung).
Short answer: Under the TV-Ärzte TdL collective agreement, the basic pay for pay group Ä1, step 1, has been 5,792.90 euros per month since 1 April 2026 for a 40-hour week (status: October 2026, Marburger Bund). In this pay range you remain in statutory health insurance, because the 2026 earnings threshold (Jahresarbeitsentgeltgrenze) is 77,400 euros per year.
The most important points
- The basic pay for Ä1, step 1 under the TV-Ärzte TdL is 5,792.90 euros per month from 1 April 2026.
- In step 2, that is in your second year, the basic pay rises to 6,121.26 euros per month.
- The 2026 earnings threshold is 77,400 euros per year. Below this threshold you remain in statutory health insurance.
- The doctors pension fund of your state replaces statutory pension insurance only if the exemption under section 6 SGB VI succeeds.
- Allowances and night or on-call duty change pay and the calculation. Check every payslip for these items.
What does a resident doctor earn under the collective agreement?
The figures in this section apply to the TV-Ärzte TdL, which covers university hospitals run by the states. The TV-Ärzte VKA has its own table, which may differ. We therefore do not quote VKA figures. Check your employment contract to see which agreement applies.
| Pay group and step | Monthly basic pay | Valid from | Source |
|---|---|---|---|
| Ä1, step 1 (first year) | 5,792.90 euros | 1 April 2026 | TdL pay table, Marburger Bund (in German) |
| Ä1, step 2 (second year) | 6,121.26 euros | 1 April 2026 | TdL pay table, Marburger Bund (in German) |
The Marburger Bund pay table gives its validity as running until 31 August 2027. After that, new figures apply under the collective agreement. Ask your employer for the current status before you decide on the basis of these numbers.
How much remains after social security contributions?
We do not calculate income tax here. For net examples, refer to the tax calculator of the Federal Ministry of Finance. The following calculation covers only social security contributions.
Assumption: basic pay Ä1 step 1 without allowances, childless and over 23 years old, average additional contribution of 2.9 percent, contributions not capped because pay is below the assessment ceiling of 5,812.50 euros per month.
| Item | Total rate | Employee share | Amount per month (assumption) |
|---|---|---|---|
| Health insurance including additional contribution | 17.5 percent | 8.75 percent | 506.88 euros |
| Long-term care insurance including childless surcharge | 4.2 percent | 2.4 percent | 139.03 euros |
| Total social security contributions (employee share) | 645.91 euros |
The figures come from the GKV umbrella association and the Federal Ministry of Health, status 2026. Your actual additional contribution depends on your health insurance fund.
Do you stay in statutory health insurance?
Compulsory insurance ends only above the earnings threshold, which is 77,400 euros per year or 6,450 euros per month in 2026. At the first-step basic pay, the annual figure is 69,514.80 euros (assumption without special payments), so the threshold is not reached. Allowances can raise annual pay, so check your payslip. An exemption from compulsory health insurance is possible only in the cases of section 8 SGB V.
Which pension provision applies to you?
If you are a member of the state medical chamber, you generally belong to the doctors pension fund of your state. It provides for old age, reduced earning capacity and surviving dependants. An exemption from statutory pension insurance follows section 6 SGB VI. If you apply within three months, it takes effect from the date the conditions were met. For the pension fund of Lower Saxony, see Ärzteversorgung Niedersachsen (in German).
Frequently asked questions
Do I get the same pay in my first and second year?
No. In the first year, step 1 applies at 5,792.90 euros, and in the second year step 2 at 6,121.26 euros (status April 2026, TdL). For further steps and changes to the agreement, the current table published by the Marburger Bund applies.
Does the TV-Ärzte TdL also cover municipal hospitals?
Usually not. Municipal hospitals often apply the TV-Ärzte VKA, whose table differs. Check in your contract which agreement applies, and do not compare the tables without checking.
Do I have to choose private health insurance after I start?
No. Below the earnings threshold you are in statutory health insurance. Above it, you can choose between statutory and private insurance. A switch requires checking deadlines and health questions. For a comparison in the first job, see Switching to Private Health Insurance at Career Start.
Where do I find the current pay table?
The Marburger Bund publishes the collective agreements and pay tables on its website under collective agreements (in German). The TdL lists the table in its overview of agreements. Check the validity period there before you pass on figures.
What to do now
- Check in your contract whether the TV-Ärzte TdL, the TV-Ärzte VKA or a company agreement applies.
- Compare the basic pay with your payslip and watch for allowances and duty shifts.
- Check whether you will be admitted to the doctors pension fund of your state and note the three-month deadline for an exemption application.
- Clarify the additional contribution with your health insurance fund and check disability and liability cover before you start work.
Related reading
- Health Insurance Income Limit 2026: What It Means
- Private Health Insurance Benefits: Doctors and Hospitals
- Assistenzarzt Gehalt: Tarif, Stufen und Nachtdienst
- Ärzte in Weiterbildung
Sources: TV-Ärzte TdL pay tables valid 1 April 2026 to 31 August 2027 (Marburger Bund, PDF, in German); Rechengrößen 2026, contribution law (GKV umbrella association, status 1 January 2026, in German); Contributions to statutory health insurance (Federal Ministry of Health, in German); Section 6 SGB VI, exemption from compulsory insurance (gesetze-im-internet.de, in German).
Last updated: October 2026. This guide is general information, not individual advice.
